When are Psychiatric Symptoms "BETTER"?

If you struggle with clinical depression or anxiety, it can be difficult to ask for help. The good news is, there are different medication and non-medication treatment options that can help. When someone is treated for depression or anxiety, the doctor will ask "How do you feel?", and most people will answer "better". But what exactly is "better"?

Currently, psychiatric symptoms like depression and anxiety do not have a blood test or physical finding to show the patient and the doctor that the patient is "better". This leads to confusion because it can be difficult to know when to change the treatment plan - if you are "better", do you stop making changes to the treatment plan? 

I think it is helpful to think about RESPONSE and REMISSION as ways to frame psychiatric treatment. Here is the way I like to think about it:

RESPONSE is when the person is demonstrating a clear improvement of symptoms. If the patient says "I am feeling better but not back to normal", and a standardized rating scale shows a 50% improvement, then the person has a RESPONSE to treatment.

REMISSION is when the person has complete resolution of symptoms. If the patient says "I am feeling back to my normal self", and a standardized rating scale shows a normal score, then the person is in REMISSION.

Once the patient is in REMISSION, then the doctor should start working on a plan for RELAPSE PREVENTION. Many psychiatric problems can recur over time, so it is very important to continue to check in with the doctor to minimize the chance and/or severity of a relapse!

Author
Dr. Jennie Byrne, M.D., PhD. With over 15 years of medical expertise, Jennie Byrne, MD, PhD, is a board-certified psychiatrist with experience treating mental health conditions in adults, including dementia, attention-deficit hyperactivity disorder, anxiety, and depression. After practicing in New York City for 12 years, Dr. Byrne relocated to North Carolina in 2008; she currently cares for patients in Chapel Hill, North Carolina, at Cognitive Psychiatry of Chapel Hill. Dr. Byrne earned her bachelor’s degree at the University of Pennsylvania in Philadelphia. She then received her doctorate from New York University Department of Neurophysiology. She also has a doctorate of medicine from New York University School of Medicine. Dr. Byrne went on to complete a psychiatry residency at Mt. Sinai School of Medicine in New York. In addition to her work as a psychiatrist, Dr. Byrne has performed extensive research on attention, memory, and depression. As a board-certified adult psychiatrist, Dr. Byrne focuses on the needs of each patient to pro

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